Endocrinology and Diabetology Unit, Hospital "M. Bufalini", Cesena, Italy.
Anatomical Pathology Unit, Hospital "M. Bufalini", Cesena, Italy.
Endocr Metab Immune Disord Drug Targets. 2021;21(8):1518-1523. doi: 10.2174/1871530321666210203213758.
Double pituitary adenomas (DA) are two morphologically and immunohystochemically different tumours in the same gland. They are rare, generally small adenomas and divided in: separated, when clearly recognizable before or during surgery, and contiguous, when diagnosed only in the following histopathological examination. Acromegaly and Cushing's disease are the main prevalent clinical presentation.
We described two cases of DA in a surgical series over 16 years in a single center.
In September 2018, we diagnosed a DA in a man with acromegaly (case 1). In order to assess the presence of other cases of DA, we performed a retrospective analysis of the endonasal endoscopically operated sellar adenomas from January 2004 to December 2019.
468 pituitary adenomas were found. A DA with a Pit-1 positive macroadenoma (GH-TSH- PRL positive) and an ACTH microadenoma clinically silent in an acromegalic woman was retrospectively found (case 2).
Our analysis confirms that DA are rare (0.4% of the pituitary adenomas) and often associated with acromegaly. Their pre-operatively diagnosis is difficult but clinician's awareness of DA can improve the diagnosis. The use of pituitary transcription factors could be useful in detecting DA.
双垂体腺瘤（DA）是同一腺体中两种形态和免疫组织化学上不同的肿瘤。它们很罕见，通常是小腺瘤，并分为：分离型，在手术前或手术中可明确识别；连续型，仅在随后的组织病理学检查中诊断。肢端肥大症和库欣病是主要的常见临床表现。
我们在 16 年的时间里在一个单中心的手术系列中描述了两例 DA。
2018 年 9 月，我们诊断了一名肢端肥大症患者（病例 1）存在 DA。为了评估是否存在其他 DA 病例，我们对 2004 年 1 月至 2019 年 12 月经鼻内镜手术切除的鞍内腺瘤进行了回顾性分析。
共发现 468 例垂体腺瘤。我们发现了一例具有 Pit-1 阳性大腺瘤（GH-TSH-PRL 阳性）和 ACTH 微腺瘤的 DA，该患者为肢端肥大症女性，后者临床无症状（病例 2）。
我们的分析证实，DA 很罕见（占垂体腺瘤的 0.4%），常与肢端肥大症相关。术前诊断困难，但临床医生对 DA 的认识可以提高诊断率。垂体转录因子的应用可能有助于检测 DA。
